VBS Registration

VBS 2012 Registration

Register for Vacation Bible School at Element Church! Our VBS takes place August 5-8 at these times:

Sunday - 2pm-6pm
Monday through Wednesday - 6:30pm-8:3pm

Please fill out the form below to register each child attending.

Child Information
Child's Name*
FirstLast
Date of Birth*
Age*
Last Grade Completed*
Address*
Street AddressCityZip Code
Special Needs / Allergies
Parent / Guardian Information
Parent's Name*
FirstLast
Primary Phone*
Email
Enter EmailConfirm Email
Name if Person Responsible for Pickup (if different from Parent)
FirstLast
Pickup Person's Phone Number
Pickup Person's Relationship to Child
Name
This field is for validation purposes and should be left unchanged.

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